title: Helicobacter pylori infection and histological changes in siblings of young gastric cancer patients.
abstract: OBJECTIVE
  Helicobacter pylori infection is a risk factor for gastric cancer. We evaluated whether H. pylori infection and premalignant histological changes are more prevalent in siblings of young gastric cancer patients.
  
  
  METHODS
  Young (age ≤ 40) gastric cancer patients (n = 185), their young siblings (n = 130), and young control participants (n = 287) were recruited. H. pylori infection and histological changes were assessed using the updated Sydney system in biopsy specimens from three regions. We analyzed the association of H. pylori infection and histological changes with gastric cancer using logistic regression analysis.
  
  
  RESULTS
  The H. pylori infection rate was significantly higher in young cancer patients than their siblings (odds ratio [OR]= 2.42, P = 0.001) or control participants (OR = 3.60, P < 0.001). In H. pylori-infected subjects, corpus gastritis and premalignant changes of the corpus lesser curvature (LCv) were also more prevalent in patients than in siblings or controls. In terms of the antrum, intestinal metaplasia was more prevalent in H. pylori-infected patients than in siblings or controls, while atrophy was not affected. Siblings also had a higher H. pylori infection rate (OR = 1.60, P = 0.046) and higher prevalence of intestinal metaplasia at the corpus LCv (OR = 2.88, P =0.027) than control participants.
  
  
  CONCLUSIONS
  Even in young adults, H. pylori infection is a risk factor for gastric cancer. Young adults with histological findings including corpus predominant gastritis, corpus atrophy, or intestinal metaplasia are at increased risk. Since young siblings share risk factors, screening and treatment should be considered for these family members.
authors.affiliation: Center for Cancer Prevention and Detection, National Cancer Center, Ilsandong-gu, Goyang, Gyeonggi, Korea.
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Nam
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Su Youn
authors.initials: SY
authors.lastname: Nam
authors.forename: Sook Ryun
authors.initials: SR
authors.lastname: Park
authors.forename: Myeong-Cherl
authors.initials: MC
authors.lastname: Kook
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000328:Adult; D001706:Biopsy; D002681:China / Q000453:epidemiology; D004200:Diseases in Twins; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D013274:Stomach Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult